A review of inpatient urology consultations in an Irish tertiary referral centre

• Published in: The surgeon (Edinburgh) 2013-12, Vol.11 (6), p.300-303
• Main Authors: Sullivan, J.F, Forde, J.C, Creagh, T.A, Donovan, M.G, Eng, M.P, Hickey, D.P, Mohan, P, Power, R.E, Smyth, G.P, Little, D.M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Appointments and Schedules; Consultation; Female; Humans; Inpatient; Inpatients; Ireland; Male; Medicine - statistics & numerical data; Middle Aged; Referral and Consultation - statistics & numerical data; Retrospective Studies; Subspecialty; Surgery; Tertiary Care Centers; Urologic Diseases - diagnosis; Urology; Urology - methods; Workload; Young Adult
• ISSN: 1479-666X; 2405-5840
• DOI: 10.1016/j.surge.2013.06.003

Abstract Introduction Our institution is a 680-bed tertiary referral centre with broad medical and surgical subspecialty services. We retrospectively audited the pattern of inpatient consultations from all specialities within our institution to the urology department over a 1-year period. Methods All consultations to the urology service were identified from our computerised inpatient consultation system from July 2010 to June 2011. Follow up data on investigations, interventions and subsequent outpatient appointments were also identified by review of individual patient discharge letters. Results Seven hundred and twenty five inpatient consultations were received over the period. The male to female ratio was 7:3. Mean age of patients was 66 (15–96) years. Seventy three percent of referrals were from medical sub-specialities, most commonly nephrology (17%), gastroenterology (11%) and respiratory medicine (9%). The remainder were from general surgery (16%) and other surgical sub specialities (11%). Interns (66%) and senior house officers (SHO) (28%) communicated the majority of consults. Male lower urinary tract/benign prostate related issues resulted in 25% of all consultations. Less than half of consults (47%) resulted in interventions initiated by urology, most commonly of which were catheter insertions (48%) and endoscopic procedures (35%). Only 43% of consultations were followed up in the outpatients setting. Conclusions Inpatient consultations constitute a significant workload for urology services. The majority of these referrals did not require any urological intervention and could have been seen routinely in the outpatient setting. Providing structured referral guidelines and achieving better communication with referring teams may help to optimise this service.